Category: Doctors and Dentists

Posted in Autism, Doctors and Dentists, Down syndrome, Dual Diagnosis Down syndrome and autism, Feeding, Personal Hygiene, Toileting, Resources for Special Needs

Blog #214~ How to Make a Social Story

Posted on by Teresa Unnerstall

Blog #214~How to Make a Social Story

A social story is a visual support that helps individuals understand new events, and reinforces a desired skill, task, or behavior.  They are useful for individuals that have Down syndrome, autism or other intellectual/developmental disabilities.  My son, Nick is 24 years old and has a dual diagnosis of Down syndrome and autism.  Over the years, we’ve used social stories to help him navigate new situations like starting back to school, doctors and dentist appointments, vacations, and independent living skills such as showering and brushing teeth.  Social stories provide a blueprint as to what will occur and what is expected from a behavior standpoint.  Knowing what will happen and what’s expected, will also help to reduce anxiety.

social-stories go to class

As you can see from the illustration above, a social story should use succinct wording and may include visual, depending on the ability and age of the child.  Individuals with autism often understand better with pictures.  Support teachers and speech therapists are great resources for creating social stories for your child.  Google Images and Pinterest both offer many social stories to help you get started.

How to Make a Social Story:

1. Choose a specific event (starting school, a doctor visit, hygiene routine).

2. Break the story down into steps, including who, what, (and why depending on the child’s cognition level).  Use the pronouns “I” or “we”.

3. State the desired behaviors that you want the person reading the story to do for each step.

4. Include visuals either on-line or actual pictures of the setting.

5. Show the desired outcome, this may include a reward or verbal praise like “good job”.

6. Read the story together with the child repeatedly for several weeks before the event or new routine occurs.

hand_washing_routine

social story morning routine

Some individuals may respond better to video modeling.  Making a video of the desired task or behavior can help a child learn a new routine, adjust to a new environment or learn a skill.  As with social stories, the script should be simple in wording and broken down step by step.

Both social stories and video based modeling can help teach new skills, venues and routines.

Here are a few more ideas for using social stories or video modeling to teach your child:

*New job skill

*Fine motor tasks (cutting food, buttoning a shirt, pouring milk, handwriting)

*Gross motor skills (swimming strokes, riding a bike, yoga, sports)

*Grooming and hygiene routines (brush teeth, shower, toileting, dressing)

*Morning, afternoon and bedtime routines

*Household chores

*School Routines ( new school, picture day, assemblies, new curriculum in PE)

*Visits to doctor, dentist, blood draws, haircuts

*Community trips, vacations and special events

*Teaching social skills (playing games with peers, turn taking)

When you know what is going to occur, you feel less anxious.  Fear can lead to avoidance for all of us.  Utilizing social stories can help guide a child to understand what will happen, where and what is expected of their behavior.  It’s a great visual tool for teaching new skills and routines.  As the new school year begins, create a social story that includes actual pictures of the school building, classroom, lunchroom, gym and any other areas your child will be in.  Social stories will help to guide your child to smooth and successful experiences both at home, school and in the community.  That’s what is in my noggin this week.

~Teresa 🙂

Follow Nick:

Facebook and Pinterest @Down Syndrome With A Slice Of Autism

Instagram @nickdsautism

Twitter @tjunnerstall

 

 

Posted in Autism, Doctors and Dentists, Down syndrome

Blog #175~ Dentist Visits for Special Needs

Posted on by Teresa Unnerstall

Blog #175~Dentist Visits for Special Needs

teeth emoji

Taking a child with special needs to the dentist can be challenging.  It ranks right up there with hair cuts and blood draws at the medical lab.  My son Nick is 23 years old, and has Down syndrome and autism.  His speech deficits and sensory issues makes it difficult to get a proper dental examination and cleaning.  Now that Nick is an adult, we changed from a pediatric dentist to one that specializes in working with adults with special needs.  The experience for my son went very well, and here’s why it was successful.

Here are 5 tips to help with dentist visits for special needs:

*1- Find a dentist who specializes in working with persons having special needs.  Get referrals from other families and therapists.

*2- Request to schedule the appointment during the quiet time at the office.

*3- Create a social story either with a written checklist or pictures for your child to follow.  For a child with autism, if they can see it, then they can understand it.  This guide will be like a map to follow, and can help to lessen anxiety.

I printed a social story from Google Images and added a highly preferred reward of Taco Bell at the end of the visit:

dentist social story

At home we have a tooth brushing sequence laminated for Nick to follow.  You can print this PDF out for your child to use:  teeth

*4- The dentist should take the time to go at your child’s pace, based on their sensitivity and level of anxiousness.  His new dentist allotted plenty of time to ease into the exam, and for Nick to get comfortable with him.  Nick didn’t want to sit in the chair right away, even with my point prompts to the social story.  First, they put one of his favorite cartoons on the flat screen TV.  Then, the dentist put his gloved hands out for Nick to touch and get use to the feel and texture.  After a few minutes along with a several high-five and elbow bumps, Nick sat down in the chair.  He continued to narrow the gap of proximity, so that Nick was could get use to him being close.

On the first visit, the dentist was able to do brief examination and brush Nick’s teeth counting to 23 (his age) twice.  He took several breaks, giving lots of praise and elbow bumps.  We scheduled another visit three weeks later to try to build Nick’s tolerance level and continue to develop their relationship.  On the second visit, he was more at ease, sitting down in the chair right away.  The dentist completed a deeper examination, as Nick was able to tolerate even more this time.  He was able to clean, floss and even brush fluoride on Nick’s teeth!

Nick dentist two

*5- The key to having success on these visits was allowing time for Nick to feel more relaxed and establishing trust.  The dentist worked slowly to desensitize, picking up on any verbal or non-verbal cues.  He adjusted his pace accordingly, to match what my son could handle.  His dentist understood the importance of building this trust and relationship, thus earning the right to provide more clinical care.

The tips of *1-finding the right dentist, *2-scheduling appointments during off times, *3-providing a social story, *4-breaking down the examination slowly and *5-establishing a trusting relationship, all helped greatly to lead to successful dentist visits.

If your child has sensitivities, you may also want to see if they can tour the office before the appointment.  If need be, ask if the lighting can be adjusted and whether they offer the use of a weighted vest (which provides deep pressure which can be calming).  In some cases, it may be necessary to sedate a child that is uncooperative or needs more advanced care.

At this time with my son, we will continue to build on the solid foundation we’ve begun with his new dentist without the use of sedation for as long as possible.  These baby steps helped to lessen Nick’s anxiety for dental visits in the future.  I appreciate the time, care and concern for my son’s best interests in providing such a positive experience.  That’s what is in my noggin this week. 🙂

~Teresa

Follow Nick:

Facebook and Pinterest @Down Syndrome With A Slice Of Autism

Instagram #nickdsautism

Twitter @tjunnerstall